Impact of Stunting on Outcomes of Severely Wasted Children (6 Months to 5 Years) Admitted for Inpatient Treatment: A Cross-Sectional Study in an Ethiopian Referral Hospital

TL;DR

This study finds that stunted children with severe wasting in Ethiopia had longer hospital stays and more weight gain but similar discharge and readmission rates compared to non-stunted children.

Contribution

The study provides new insights into the impact of stunting on hospitalized children with severe wasting in a sub-Saharan setting.

Findings

Stunted children had a longer hospital stay by 3 days compared to non-stunted children.

Stunted children showed greater weight gain (4 g/kg/day) than non-stunted children.

Discharge and readmission rates were similar between stunted and non-stunted children.

Abstract

Background: Undernutrition is a major public health concern, accounting for nearly half of global under-five mortalities and leading to serious long-term consequences for those who survive. Most nutritional screening programs give priority to acute undernutrition (wasting). The co-presence of chronic undernutrition (stunting) has been shown to have the highest risk of mortality. To date, few studies have assessed outpatient treatment outcomes of children with wasting + stunting (WaSt), with some inconsistencies in results and only one study having investigated the outcome of patients requiring hospitalization. The aim of the present study is to investigate the impact of stunting on the outcomes of severely wasted children admitted for inpatient treatment in an Ethiopian referral hospital. Methods: A retrospective cross-sectional study was conducted to compare treatment outcomes (length of hospital stay, weight gain, recovery rate, readmission rate) of wasted and WaSt children admitted to “St. Luke Catholic Hospital and College of Nursing and Midwifery” between January 2018 and February 2023. Results: The analysis comprised 616 children aged 6–60 months and stunting was diagnosed in 559 children (90.7%). Children with stunting had a longer length of stay (median difference 3 days, 95% confidence interval 0 to 5; p = 0.03) and improved weight gain (median difference 4 g/kg/day, 95% confidence interval 0 to 4; p = 0.002) compared to children without stunting. Discharge rate (p = 0.99) and readmission rate (p = 0.25) were not statistically different between children with or without stunting. Conclusions: Stunting was found to be present in most children admitted for severe wasting to the Stabilization Centers in a sub-Saharan setting. Stunting was associated with longer hospitalization and greater weight gain, but discharge and readmission rate were comparable between children with or without stunting.

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